Managing Diabetes During Cold and Flu Season

Cold and flu season can complicate your plan for managing diabetes. Try these self-care tips when cold-weather illnesses set in.

Cold
and flu season is challenging even for healthy people, but when you’re also managing
diabetes, it can have more serious consequences. Cold medications, dehydration,
irregular eating schedules, and your body’s response to infection can all make
managing diabetes more challenging, which can lead to higher or lower blood
sugar than you might ordinarily expect. It’s important to pay attention to the heightened
risk of diabetes complications during this time, which can range from dehydration
to pneumonia.

“Some
people with diabetes can get severely ill with a cold or the flu,” says
endocrinologist Debra Simmons, MD, a professor of medicine at the University of
Utah in Salt Lake City. “Blood sugar can become harder to control, and you
might not be able to keep fluids down.”

Taking Care of
Yourself During Cold and Flu Season

Get your flu
shot.
“Everybody with diabetes is supposed to get a flu shot,” Dr. Simmons says. It’s
one of your best defenses along with washing hands regularly and avoiding
people who are sick.

Get the
pneumonia vaccine. This adult vaccination, called pneumovax, can protect you against a number of
pneumonia strains. Unlike the flu shot, which is given annually, you can get it
once and then forget about it for a few years.

Have a sick-day
plan in place. If you haven’t already discussed your “sick day rules” with your doctor, do so now.
Ask what medications you can safely take to treat cold and flu symptoms, how to
adjust your own medications if necessary, and when to call him or her if you
get really sick and need more help.

Buy diabetes-friendly cold products. The cough
syrups most people rely on during cold and flu season tend to be sugary, so
check labels carefully to make sure the ones you buy are flavored only with
sugar-free syrups. Avoid decongestants because ingredients like pseudophedrine
or phenylephrine can make diabetes harder to control. If your nose is stuffy,
try a saline nasal spray instead. Also, look for alcohol-free medications
because alcohol can affect blood sugar.

Pay attention to
other possible drug interactions. Just as syrupy medications can upset
your blood sugar, certain cold and flu medications can increase blood pressure. If, like many people with diabetes, you’re also on blood pressure medication
and aren't sure what cold products are best for you, talk to your doctor or
pharmacist, and bring along a list of all your medications for this discussion.

Ask for help if
you need it. If an illness becomes severe, taking care of yourself can be difficult, Simmons
says. If you can’t manage all the demands of diabetes and a cold, ask a friend
or family member to check in on you regularly until you feel better. He or she
should know how and when to call your doctor.

Check blood
sugar levels often. Typically you may test your blood sugar just once or twice a day when you’re
well, but if you’re sick, aim for every 2 to 4 hours until the cold or flu has
subsided.

Take medications
on schedule. Even if you're having trouble eating and keeping food down, take your diabetes medications
on schedule. If you have any doubts about when to take them or how much to take,
especially insulin doses, call your doctor.

Drink fluids
regularly. Make sure you stay hydrated. If you’re having trouble eating, ask your doctor
about trying a small amount of a sweetened drink, such as half of a cup of soda
or a sports drink. You’ll need 45 to 50 grams of carbohydrates every 3 to 4 hours.
Consider ice chips or an ice pop if you’re having a hard time keeping fluids
down.

Test your urine
for ketones. If your blood sugar goes over 240 mg/dL, test your urine for ketones,
substances that build up in the urine or blood when your body is not getting or
using blood sugar properly. This can be dangerous, so inform your doctor if
your ketone test is positive.

Prep your pantry. When you’re
sick, you may not have the energy to get to the store. Keep a variety of items on
hand just in case, such as canned soups, fruits, and vegetables. Consider
having some ginger ale (regular, not diet) on hand in case you need fluids with
some carbohydrates.

Keep a log. Write down what
medications you’re taking and when, as well as the results of blood sugar
tests, ketone tests, your temperature, what you've eaten, and whether you've
had any bouts of diarrhea or vomiting — all stats your doctor will
need to know if your symptoms get worse.

When to Call
Your Doctor

If
you get sick, you or a loved one should call your doctor if:

Your
cold or flu symptoms don’t start to get better in about 72 hours or if they get
worse.

Your
blood sugar levels are too high (over 250 mg/dL) or too low (70 mg/dL) and you aren't able to adjust them.

You
have ketones in your urine.

You
have abdominal pains.

You
have a fever of 101.5 or higher.

You
have ongoing diarrhea or are vomiting.

You’re
experiencing shortness of breath, dizziness, or any loss of consciousness.

You’re
having a hard time thinking clearly or staying awake.

If
you have diabetes, cold and flu season can be extra challenging. But with some preparation
and a plan, you can make it through while keeping your diabetes in check.

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